Author: Mr Oliver Eaton BSc (Hons), PG.Cert – Orthopaedic Specialist
Reviewed by: Mr William Sharples BSc (Hons) – Pain Management Expert
Last Updated: September 2025
In this article, you will find out everything you need to know about spinal stenosis and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
Understanding Spinal Stenosis Pain
Spinal stenosis pain is often described as aching, burning, or shooting pain in the back, buttocks, or legs, with leg pain being a specific and common example. It may worsen with walking or standing and improve with sitting or bending forward. Numbness, tingling, and muscle weakness are also common symptoms, often resulting from compression of the spinal nerves. These symptoms of spinal stenosis can vary in severity and presentation among patients [1].
Diagnostic tests such as MRI or CT scans are used to assess the condition of the spinal nerves and help confirm spinal stenosis diagnosed.
Diagnostic Tests for Spinal Stenosis
Accurate diagnosis is essential for effective treatment of spinal stenosis. Healthcare providers use a variety of diagnostic tests to assess the condition of the spinal cord, nerve roots, and spinal canal. The most common and informative test is magnetic resonance imaging (MRI), which produces detailed images of the spinal structures and can reveal any narrowing, nerve compression, or damage. MRI is especially useful for visualizing soft tissues and identifying the exact location and severity of spinal stenosis.
Computed tomography (CT) scans are another valuable tool, offering cross-sectional images that help detect bone spurs and assess the density and alignment of the spinal bones. X-rays are often used to evaluate the overall alignment of the spine and to look for signs of arthritis or other changes that may contribute to spinal stenosis. In some cases, a myelogram may be performed, which involves injecting a contrast dye into the spinal canal to highlight areas where the spinal cord or nerve roots may be compressed.
These diagnostic tests provide crucial information that guides the development of a personalized treatment plan, which may include physical therapy, medication, or spinal surgery, depending on the severity and location of the stenosis.
Best Painkillers for Spinal Stenosis Pain Relief
The best painkiller for spinal stenosis depends on the severity of symptoms, other health conditions, and individual response. Over the counter medications are often the first step in pain management for spinal stenosis, providing accessible options for initial symptom control. Common options include:
- Paracetamol (Acetaminophen): Often recommended for mild pain. It is generally safe but may be less effective for nerve-related pain.
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Medications like ibuprofen or naproxen help reduce inflammation and pain. They are effective for many but should be used with caution in people with stomach, kidney, or heart issues [2].
- Pain Relievers: Both over the counter medications (such as acetaminophen and NSAIDs) and prescription medications (such as certain opioids or neuropathic agents) are used as pain relievers to manage spinal stenosis symptoms.
- Neuropathic Pain Medications: Drugs such as gabapentin, pregabalin, or amitriptyline target nerve pain and may be prescribed if standard painkillers are not effective [3].
- Opioids: Stronger painkillers like codeine or tramadol may be used for short periods in severe cases, but they carry risks of dependence and side effects and are not recommended for long-term use. Prescription medications, including opioids and other potent drugs, are considered when over the counter medications and other therapies do not provide sufficient relief.
- Muscle Relaxants: Medications such as baclofen, cyclobenzaprine, or methocarbamol may be prescribed to relieve muscle spasms and are often used as part of a comprehensive pain management plan.
- Topical Treatments: Creams or patches containing NSAIDs or capsaicin can provide local pain relief with fewer systemic side effects.
Some medications work by blocking or reducing the transmission of pain signals from the nerves to the brain, helping to block pain signals and provide relief from discomfort.
Always consult your doctor before starting any new medication, as they can help tailor the best pain relief plan for your needs. Achieving effective pain relief and adequate relief is the primary goal of pain management for spinal stenosis. If these are not achieved with initial therapies, stronger or alternative treatments may be considered to ensure sufficient relief.
Anti-Inflammatory Drugs and Chronic Pain
Managing chronic pain from spinal stenosis often involves the use of anti-inflammatory drugs. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are commonly recommended to reduce inflammation and relieve pain by blocking the chemicals in the body that cause swelling and discomfort. These medications can be particularly helpful in alleviating pain and improving mobility in the short term.
For some individuals, corticosteroids may be prescribed to provide a stronger anti-inflammatory effect, especially when there is significant swelling or nerve root irritation. These medications can help relieve pressure on the spinal cord and nerve roots, offering relief from persistent pain.
While anti-inflammatory drugs can be effective, it’s important to use them under the guidance of a healthcare provider, as long-term use can lead to side effects such as stomach irritation or kidney issues. Combining these medications with physical therapy and other nonsurgical treatments can provide a comprehensive approach to managing chronic pain and improving quality of life for those with spinal stenosis.
Epidural Steroid Injections for Spinal Stenosis
Epidural steroid injections are a widely used treatment for individuals experiencing severe pain and inflammation due to spinal stenosis. This procedure involves injecting a corticosteroid medication directly into the epidural space around the spinal cord, targeting the area where nerve roots may be compressed or irritated.
The primary goal of epidural steroid injections is to reduce inflammation and relieve pressure on the affected nerves, which can provide significant, though temporary, relief from spinal stenosis symptoms. Many patients find that these injections help them manage severe pain and allow them to participate more fully in physical therapy and daily activities.
The effects of epidural steroid injections can last from several weeks to a few months, and the procedure is typically performed on an outpatient basis with local anesthesia. While generally safe, there are potential risks such as infection, bleeding, or nerve damage, so it’s important to discuss the benefits and risks with your healthcare provider to determine if this treatment is appropriate for your situation.
Physical Therapy for Spinal Stenosis
Physical therapy is a cornerstone of nonsurgical treatment for spinal stenosis, offering effective ways to relieve pain, improve function, and enhance overall quality of life. A skilled physical therapist will design a personalized exercise program tailored to your specific symptoms and abilities, focusing on strengthening the core and back muscles that support the spine.
Therapeutic exercises may include gentle stretching to increase flexibility, as well as strengthening routines to stabilize the spine and reduce pain. Physical therapists may also use modalities such as cold therapy, heat therapy, ultrasound, and transcutaneous electrical nerve stimulation (TENS) to help manage pain and inflammation.
In addition to hands-on treatments, physical therapists provide valuable education on posture, body mechanics, and ergonomics, empowering you to manage pain and prevent further injury. By committing to a regular physical therapy program, many people with spinal stenosis experience reduced pain, improved mobility, and a better quality of life.
Lifestyle Modifications to Manage Spinal Stenosis Pain
Making positive lifestyle changes can play a significant role in managing spinal stenosis pain and supporting long-term spinal health. Maintaining a healthy weight helps reduce pressure on the lumbar spine and spinal canal, while regular low-impact exercise—such as walking, swimming, or cycling—can improve mobility and strengthen the muscles that support the spine.
Paying attention to posture and practicing proper body mechanics during daily activities can help prevent additional strain on the spine and reduce the risk of further injury. Quitting smoking is also important, as it can improve blood flow and reduce inflammation throughout the body, supporting better healing and spinal health.
Managing stress through relaxation techniques like meditation, deep breathing, or gentle yoga can help decrease muscle tension and inflammation, further alleviating pain. By adopting these lifestyle modifications, individuals with spinal stenosis can better manage their symptoms, reduce their reliance on pain medication, and enjoy a higher quality of life. Always consult with your healthcare provider before starting new exercise routines or making significant changes to your daily habits.
Other Treatments for Spinal Stenosis Pain: Physical Therapy and More
- Lumbar Stenosis: Lumbar stenosis is a common form of spinal stenosis that causes persistent discomfort, pain, and difficulty with daily activities, often requiring targeted management strategies.
- Physical Therapy: Targeted exercises to strengthen the back and core, improve flexibility, and support spinal health [4].
- Spinal Injections: Spinal injections, such as epidural steroid injections, deliver medication directly to the affected spinal area to reduce inflammation and nerve irritation, providing temporary relief for some patients.
- Minimally Invasive Surgery: Minimally invasive surgery uses small incisions and specialized tools to gently access and decompress the spine, minimizing disruption to surrounding tissues and reducing recovery time [5].
- Surgery: Surgical intervention is typically reserved for severe symptoms that do not respond to other treatments. Options include laminectomy, laminoplasty, or spinal fusion, and the goal is to relieve spinal stenosis symptoms and improve quality of life.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat spinal stenosis. Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with spinal stenosis. As prolotherapy is helping to treat the root cause of spinal stenosis, it is deemed to be a permanent fix, preventing the symptoms from returning.
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Case Study: Lasting Relief from Spinal Stenosis Pain
Patient: Female, 64, retired teacher
Symptoms: 3 years of lower back pain, muscle pain, leg numbness, difficulty walking, and occasional muscle spasms.
Treatment: After limited benefit from painkillers and physical therapy, she received a series of prolotherapy injections at ProHealth Clinic.
Outcome: Within 2 months, she achieved adequate relief, with pain reduced by 75%, walking distance improved, and a return to daily activities. At 1-year follow-up, she remained active with minimal symptoms.
Frequently Asked Questions
What is the safest painkiller for spinal stenosis?
Paracetamol is generally considered the safest for most people, but it may not be effective for nerve pain. NSAIDs are effective but should be used with caution in those with certain health conditions. Always consult your doctor for personalized advice.
Can I take painkillers long-term for spinal stenosis?
Long-term use of painkillers, especially opioids and NSAIDs, is not recommended due to potential side effects and risks. Non-drug treatments and regenerative therapies like prolotherapy may offer longer-lasting relief.
Are there alternatives to painkillers for spinal stenosis?
Yes. Physical therapy, epidural injections, minimally invasive procedures, and prolotherapy are effective alternatives that address the underlying cause of pain rather than just masking symptoms. Massage therapy is a valuable complementary treatment that can help alleviate pain, relieve muscle tension, and increase blood flow. Strengthening the core muscles through physical therapy is important for managing pain and preventing further issues. Alternative therapies such as acupuncture and herbal remedies can assist in reducing inflammation and relieving pain. Some treatments, like NSAIDs and injections, specifically aim to relieve inflammation, which is important for symptom control. Managing pain often involves a combination of therapies, including lifestyle modifications. Early intervention and lifestyle changes can help prevent spinal stenosis from worsening.
Is prolotherapy safe for spinal stenosis?
Prolotherapy is considered safe when performed by experienced practitioners. Side effects are rare and usually mild, such as temporary soreness at the injection site. Always consult a qualified provider for assessment and treatment.
How long does it take to see results from prolotherapy?
Many patients notice improvement within weeks, with optimal results typically seen after a series of treatments over 2-3 months.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating spinal stenosis, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with spinal stenosis and providing effective treatment options to alleviate them.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
References
- Genevay S, Atlas SJ. Lumbar spinal stenosis. Best Pract Res Clin Rheumatol. 2010;24(2):253-265. View Study
- Katz JN, Harris MB. Clinical practice. Lumbar spinal stenosis. N Engl J Med. 2008;358(8):818-825. View Study
- Finnerup NB, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015;14(2):162-173. View Study
- Zaina F, Tomkins-Lane C, Carragee E, Negrini S. Surgical versus non-surgical treatment for lumbar spinal stenosis. Cochrane Database Syst Rev. 2016;1:CD010264. View Study
- Mekhail N, et al. Interspinous process devices for lumbar spinal stenosis: an evidence-based review. J Pain Res. 2022;15:123-134. View Study
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.